Clinical analysis of postsurgical gastroparesis syndrome after radical gastrectomy for gastric cancer

doi:10.3877/cma.j.issn.1674-0793.2009.01.008

Abstract

Abstract:

Objective

To analyze the etiology，diagnosis and treatment of postsurgical gastroparesis syndrome(PGS)after radical gastrectomy for gastric cancer.

Methods

Clinical datum of 500 cases with radical gastrectomy for gastric cancer were collected from January 2003 to April 2007,12 cases with PGS were enrolled.The clinic manifestation, process of diagnosis, treatment and high risk factors for PGS were analyzed.

Results

Patients with anxiety and preoperative gastric outlet obstruction were easily complicated PGS(P＜0.01).The risk of PGS with Billroth Ⅱgastrojejunostomy were much higher than Billroth I.The patients with PGS were usually recovered by non-operative treatments,and average recovery time was(28.64±15.74)d.EN+PN could more obviously shorten the recovery time than TPN (P＜0.05).

Conclusions

PGS is induced by multiple factors.Radiography of the upper gastrointestinal tract and gastroscopy are main diagnostic modalities for PGS.Non-operative treatments are effective for PGS，and reoperation should be avoided in patients with PGS.

Key words: Radical gastrectomy, Gastric cancer, Gastroparesis, Treatment

Dong-feng ZHOU, Hong-mei LI, An-xing YU, Hong LI, Zhao-feng DOU. Clinical analysis of postsurgical gastroparesis syndrome after radical gastrectomy for gastric cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2009, 03(01): 28-31.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2009.01.008

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2009/V03/I01/28

Figures/Tables 2

References 12

1	刘凤林,秦新裕.根治性胃大部切除术后胃瘫综合征的回顾性研究.中华胃肠外科杂志,2002,5(4):245-248.
2	Kovach SJ,Hendrickson RJ,Cappadona CR,et al.Cryoablation of unresectable pancreatic cancer.Surgery,2002,131(2):463-464.
3	Tomita.R,Takizawa H,Tanjoh K.Physiologic effects of cisapride on gastric emptying after pylorus preserving gastrectomy for early gastric concer.World J Surg,1998,22(1):35-41.
4	王长弘,丛中.临床心理治疗学.北京：人民军医出版社,2001.577-578.
5	Frederic E,Conrad M,Knol JA,et al.Safety and long term durability of completion gastrectomy in 81 patients with postsurgical gastroparesis syndrome.Am Surg,1998,64(3):711-716.
6	池金凤,李文静,赵国丽,等.术前焦虑的原因分析及护理对策.护理研究,2005,19(11B):2351-2352.
7	Macallum Rw,Poleallest,Schirmer B,et al.Completion gastrectory for refractory gastroparesis following surgery for pepotic ulcer disease Long-term follow-up with subjective and objective parameters.Dig Dis Sci,1991,36(5):1556-1561
8	杨维良,赵刚,张新晨.胃切除术后残胃胃瘫综合症的临床总结.中华胃肠外科杂志,2002,5(4):249-251.
9	Stanciu GO.Gastroparesis and its management.Rev Med ChirSoc Med Nat Iasi,2001,10(25):451-456.
10	蒋阳平,孙洪明,俞鸣翔.胃癌术后早期肠内营养支持.浙江医学,2002,24(10):633.
11	相元明,张勇,王寿春,等.中西医结合治疗术后胃瘫综合征.现代中西医结合杂志,2004,13(15):2031-2032.
12	Thomas L, Abell, Jean Luo, et al. Long term treatment at gastric electrical stimulation is associated with changes in neuro-enteric function. Gastroenterology,2000,95(S):2447-2471.

组别	例数	年龄（岁）		性别		低蛋白症		焦虑评分		吻合方式		术前流出道梗阻
组别	例数	≥60	＜60	男	女	有	无	≥45	＜45	毕Ⅰ	毕II	有	无
PGS组	12	7	5	5	7	3	9	5	7	3	9	7	5
非PGS组	488	310	178	206	282	60	428	27	461	221	267	72	416
χ²值		0.004		0.001		0.757				3.883		13.604
P值		0.948^*		0.970^*		0.384^#		＜0.01^△		0.049^#		＜0.01^*

组别	例数	年龄（岁）		性别		低蛋白症		焦虑评分		吻合方式		术前流出道梗阻
组别	例数	≥60	＜60	男	女	有	无	≥45	＜45	毕Ⅰ	毕II	有	无
PGS组	12	7	5	5	7	3	9	5	7	3	9	7	5
非PGS组	488	310	178	206	282	60	428	27	461	221	267	72	416
χ²值		0.004		0.001		0.757				3.883		13.604
P值		0.948^*		0.970^*		0.384^#		＜0.01^△		0.049^#		＜0.01^*

[1]	Baicheng Yi, Xuguang Li, Rongrong Wang, Xinxuan Wang. Treatment of calcified root canals in upper anterior teeth using digital 3D-printing guides：A clinical report of two cases [J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(06): 385-390.
[2]	Huayue Yan, Zixiang Liu, Shaobo Zhou. Research progress of phosphoenolpyruvate carboxykinase-1 in malignant tumors [J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(06): 452-456.
[3]	Huazhi Li, Guang Cao, Diangang Liu, Yajing Zhang. Clinical comparison of descending hepatectomy with different approaches for primary hepatocellular carcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 52-55.
[4]	Hao Chen, Meng Wang. Advances in clinicopathological features and treatment options of sig-ring cell carcinoma of the stomach [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 108-111.
[5]	Yuefang Xu, Wang Liu, Miaotian Zeng, Yushu Guo. Clinical efficacy of polymyxin B and polymyxin E in the treatment of surgical multi-drug resistant infections Security analysis [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 700-703.
[6]	Xianyong Liu, Dongmei Qin, Ruomei Zhang, Junjiao Li, Chunqin Meng, Mingxin Wu, Yuhong Wang, Xinxian Zhao, Ruilian Xv, Wenwen Hong, Ling Ma, Wei Qiu, Yu Zhou. Expression and significance of Her2/Hes1 in three pathological stages of Correa cascade in intestinal gastric cancer [J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2024, 14(06): 321-327.
[7]	of Organ Transplantation of Chinese Medical Association Branch. Chinese practice guidelines for diagnosis and treatment of ischemic-type biliary lesion after liver transplantation [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 739-748.
[8]	Yifan Li, Diwen Zhu, Weixin Ren, Yingjun Bao, Junpeng Gu, Haixiao Zhang, Gengfei Cao, Weizheng Ji. Role of serum GP73 level in the evaluation of TACE efficacy for primary liver cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 825-830.
[9]	Qiusheng Wang. Diagnosis and treatment strategy for benign biliary diseases [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(06): 779-782.
[10]	Anti-Cancer Association China, Committee of Colorectal Cancer CACA the. CACA guidelines for holistic integrative management of anal cancer （2024 Edition） [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(06): 441-449.
[11]	Xuefeng Zhou, Zheyi Dong, Zhe Feng, Guangyan Cai, Xiangmei Chen. Formulation protocol of guidelines for diagnosis and treatment of diabetic kidney disease with integrated traditional Chinese and Western medicine [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(06): 301-305.
[12]	Bin Shi, Yuan Si. Effect of Yiqiheluo formula combined with valsartan in the treatment of IgA nephropathy with deficiency of both qi and yin plus blood stasis syndrome [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(06): 306-312.
[13]	Wenkai Guo, Pengcheng Ji, Jingru Bi, Yuansheng Xie. Ten treatment measures for IgA nephropathy [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(06): 327-333.
[14]	Xuan Tie, Xiaole Su, Lihua Wang. Progress of research on the treatment of anti-neutrophil cytoplasmic antibody-associated vasculitis [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(06): 345-351.
[15]	Tianyu Wu, Zixuan Liu, Puxin Yang, Siming Jia, Kai Ding, Xiaodong Cheng, Yonglong Li, Wei Chen, Hongzhi Lyu, Qi Zhang. Progress in Conservative Treatment of Lumbar Disc Herniation [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(06): 379-384.

Please choose a citation manager

Content to export